| Fjm Medical Clinic-basecamp | |
|
185 S State St Ste 208 Salt Lake City UT 84111-1558 | |
| (801) 821-5454 | |
| (801) 821-5455 |
| Full Name | Fjm Medical Clinic-basecamp |
|---|---|
| Speciality | Family Medicine |
| Location | 185 S State St Ste 208, Salt Lake City, Utah |
| Authorized Official Name and Position | Darce A Latsis (OPERATIONS MANAGER) |
| Authorized Official Contact | 8014411002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fjm Medical Clinic-basecamp 560 S 300 E Ste 275 Salt Lake City UT 84111-3586 Ph: (801) 441-1002 | Fjm Medical Clinic-basecamp 185 S State St Ste 208 Salt Lake City UT 84111-1558 Ph: (801) 821-5454 |
| NPI Number | 1255858734 |
|---|---|
| Provider Enumeration Date | 08/25/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255858734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 70786441205 (Utah) | Primary |
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